Traumatic Brain Injury

1. Mild Traumatic Brain Injury: An individual is awake but might display signs of confusion, memory loss, disorientation, and a brief loss of consciousness.
2. Moderate Traumatic Brain Injury: An individual is lethargic. The person might experience a loss of consciousness for 20 minutes to 6 hours. Also, a person can experience sleepiness because of brain swelling.
3. Severe Traumatic Brain Injury: An individual is unconscious: The person loses consciousness for more than 6 hours.

Common causes of Traumatic Brain Injuries

TBI can result from two types of head injury; Closed head injury and penetrating head injury.

Causes of closed head injury include:

• Falls
• Motor vehicle accidents
• Sport injuries
• Being struck by an object
• Blast injuries from explosions

Causes of penetrating head injury include:

• A hit from shrapnel or bullet
• Struck by a weapon like a knife, hammer, or baseball bat
• A Head injury that causes a bone fragment to penetrate the skull

Also, there are some accidents such as natural disasters, explosions, and other extreme events that can cause both closed and penetration traumatic brain injury in a person.

What Are the Major Types of Traumatic Brain Injuries ?

Concussion

A concussion is a minor head injury that often results in a brief loss of consciousness. It happens when the impact to the head is serious enough to cause a brain injury.
If the impact is severe, the brain will hit against the wall of the skull or force a sudden acceleration or deceleration. Typically, the symptoms of a concussion are temporary. But repeated concussion can lead to severe or permanent damage to the brain.

Hematoma

A Hematoma occurs when a blood vessel ruptures, leading to a formation of blood clots outside blood vessels. A hematoma might be small or large.

When a hematoma occurs in the brain, it compresses the brain. This might lead to pressure buildup inside the skull. As a result, an individual can experience a loss of consciousness or experience permanent brain damage.
Over time the body reabsorbs the blood clot. But if the blood clot is large, the person might have to undergo surgery for it to be removed.

There are different types of hematoma, depending on the location of the clot forms.

1. Epidural Hematoma: Blood clot forms between the skull and the brain’s dura lining.
2. Subdural Hematoma: Blood clot develops between the brain and the dura.

Subarachnoid Hemorrhage

Subarachnoid hemorrhage is uncontrolled bleeding in the space around the brain. It occurs when small arteries tear during a head injury. The blood then spreads to other areas of the brain surface, causing headaches, vomiting, and other effects. Sometimes the brain tissues can bleed, causing a condition called intracerebral hemorrhage.

Skull Fracture

The skull lacks a bone morrow, meaning it’s very strong and hard to break. However, if the skull gets fractured, it cannot absorb the impact of a blow, meaning the brain might also experience some damage too.

Diffuse axonal injury (DAI)

A Diffuse axonal injury is when the brain nerve cells sheer and stretch at the cellular level. It happens when the brain moves back and forth in the skull after an impact.

This movement causes the tearing and damaging of the axon nerves. As a result, the brain swells, and the normal transmission of nerve impulses get disrupted. DAI is the most dangerous form of traumatic brain injury since it can lead to a substantial change in brain function and can lead to brain damage or even death.

What are The Symptoms of Traumatic Brain Injury ?

Traumatic brain injury symptoms vary depending on the injury and how severe the brain damage is. The common symptoms include:

Mild symptoms

• Headaches
• Confusion
• Dizziness
• Lightheadedness
• Unpleasant taste in the mouth
• Change in sleeping patterns
• Loss of sensation
• Memory, thinking, concentration, and attention troubles
• Fatigue or lethargy
• Ringing in the ears

Additional symptoms

• A headache that doesn’t go away.
• Convulsions and seizures
• Repeated nausea or vomiting
• Loss of concentration
• Numbness and weakness of arms and legs
• Bowel and bladder changes
• Slurred speech

How is Traumatic Brain Injury Diagnosed ?

Individuals who have experienced a head injury or any other head trauma that might cause TBI must seek medical attention as soon as possible.
A health care provider will diagnose TBI by asking you questions about your symptoms and details of the injury. A doctor will also assess your injury via a Glasgow Coma Score (GCS), which is a 15-point test that evaluates the consciousness.

The score usually runs between 3- 15. It helps a doctor assess and classify your brain damage as mild, moderate, or severe. A higher score (13-15) shows a mild TBI, an average score (9-12) indicates moderate TBI, and a lower score (8 and below) indicates severe TBI.

The doctor will also examine a person for signs of trauma, such as swelling and bruising. Doctors might also perform a neurological test. This test will help them evaluate your nerve function by assessing your eye movement, muscle control, strength, among other things.
MRI (Magnetic Resonance Imaging) and CT (Computed Tomography) scans are always used to diagnose TBI.

A CT scan will provide detailed images of anatomical structures within the brain. Through a CT scan, a doctor can look at evidence of brain swelling, damage of venous sinuses, bleeding and clotting, and other forms of structural damage.

An MRI provides a more detailed view of the brain and is usually done once the patient is in stable condition.

Treatment of Traumatic Brain Injury

Treatment of traumatic brain injury depends on a lot of factors, including severity, size, and location of the brain injury.
Mild TBI: The primary treatment for mild traumatic brain injury is rest. People who experience headaches can take pain relievers. Rest is important because it shortens the recovery period. If the symptoms worsen, individuals should seek medical assistance.

Moderate and severe TBI: Before treating moderate and severe traumatic brain injuries, doctors always stabilize the patient first. They manage blood pressure, check the pressure inside the patient’s skull, and ensure the brain receives enough blood and oxygen. Once a patient is stable, they will start treatment. The treatment involves:

Surgery

Surgery will reduce any extra damage to the patient’s brain. Through surgery, doctors will remove hematomas, repair fractured skull, ease pressure in the skull and remove damaged or dead brain tissues.

Medication

Patients with severe traumatic brain injuries might receive anti-seizure medications from doctors since they’re at risk of experiencing seizure’s in the week following the injury. Patients will also receive other medicines to treat different symptoms of traumatic brain injury, including:

• Anticoagulants which prevent blood clots
• Antidepressants which treat symptoms of depression and mood instability
• Anti-anxiety to reduce the feeling of nervousness and fear
• Stimulants to boost alertness and attention
• Muscle relaxants which alleviated muscle spams

Rehabilitation

A rehabilitation program is an important part of the recovery process in TBI patients. Once patients get discharged from the hospital after their condition has stabilized, they will require TBI rehabilitation to recover fully.
A social worker will work with the patient’s family as they make preparations to transfer the patient to a rehabilitation center or long-term care facility. Some patients return home and receive health care from home.

Long-term care facilities: This is a place for patients who’ve stabilized from traumatic brain injury but still need ventilators or constant nursing care.
Rehabilitation centers: This place homes TBI patients who’re off ventilators but still need help to perform daily activities. In this center, patients receive help from a physical and occupational therapist.

Role of Rehabilitation Centers and Long-term care facilities

The recovery rate of an individual suffering from severe TBI depends on the brain’s plasticity. Brain plasticity is the ability of healthy parts of the brain to undertake the function of the damaged parts of the brain. It entirely depends on the regeneration and repair of nerve cells.

TBI rehabilitation program helps patients to regain the functionality of their damaged brain area by re-learning and compensating for lost abilities.

Traumatic Brain Injury Rehabilitation services include therapies for emotional support, physical difficulties as well as cognitive issues.

• Physical therapy: Helps patients build muscle strength, balance, flexibility, and coordination.
• Occupation therapy: Helps patients learn and re-learn how to perform daily activities like feeding, toileting, bathing, dressing, and moving from one location to another.
• Speech therapy: Speech therapists help patients with speech and language as well as cogitation. Also, they monitor their ability to swallow food safely.
• Cognitive therapy: Improves the patient’s memory, attention, judgment, planning, perception, thinking, and learning.
• Psychological counseling: Helps patients learn to cope up with skills, improve their emotional well-being, and help them work on relationships.